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Millennium Development Goals
CHILD
AND THE
DREN
Progress towards A World Fit for Children
BAN KI-MOON, SECRETARY-GENERAL OF THE UNITED NATIONS
Prepared by UNICEF
for the United Nations
December 2007
US $15.00
ISBN: 978-92-806-4219-3
Sales no.: E.08.XX.7
CHILDRENANDTHEMILLENNIUMDEVELOPMENTGOALS PROGRESSTOWARDSAWORLDFITFORCHILDREN
This is an adapted version of the Secretary-General’s report ‘Follow-up
to the special session of the General Assembly on children’ (A/62/259)
of 15 August 2007, considered by the General Assembly at its sixtysecond session in September 2007. It contains updated data and
presents information from 121 country and territory reports. For a full
list of participating countries and territories, see Annex, page 90.
United Nations Children’s Fund
3 United Nations Plaza
New York, NY 10017, USA
Email: [email protected]
Website: www.unicef.org
Photo Credits
Cover photos (top) © UNICEF/HQ07-0430/Giacomo Pirozzi (bottom, left to
right) © UNICEF/HQ07-0818/Nicole Toutounji, © UNICEF/HQ06-0435/Giacomo
Pirozzi, © UNICEF/HQ06-0302/Giacomo Pirozzi, © UNICEF/HQ05-0837/Josh
Estey, © UNICEF/HQ02-0646/Alejandro Balaguer, © UNICEF/HQ05-1357/Malvina
Bezhaeva Preface © UN Photo/Mark Garten Chapter 1 © UNICEF/HQ06-0992/
Shehzad Noorani Chapter 2 © UNICEF/HQ04-0916/Shehzad Noorani Chapter 3
© UNICEF/HQ05-2202/Giacomo Pirozzi Chapter 4 © UNICEF/HQ06-1700/Rasul
M. Taynan Chapter 5 © UNICEF/HQ06-2798/Bruno Brioni Chapter 6 © UNICEF/
HQ07-0797/Nicole Toutounji
© United Nations Children’s Fund (UNICEF)
December 2007
Permission to reproduce any part
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ISBN: 978-92-806-4219-3
Sales no.: E.08.XX.7
Millennium Development Goals
CHILD
AND THE
DREN
Progress towards A World Fit for Children
BAN KI-MOON, SECRETARY-GENERAL OF THE UNITED NATIONS
CHAPTER 1
What have we done for children?. . . . . . . . . .1
Opportunities for participation . . . . . . . . . . . . . 2
Children in war . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Exposed to natural disasters. . . . . . . . . . . . . . . . 4
Born in an era of globalization . . . . . . . . . . . . . . 5
Growing up in poverty or wealth . . . . . . . . . . . . 5
Millennium Development Goal 1 . . . . . . . . . . . . 5
Commitment to children . . . . . . . . . . . . . . . . . . .7
Investment in children . . . . . . . . . . . . . . . . . . . . 8
Building partnerships . . . . . . . . . . . . . . . . . . . . 10
Legislating for children’s rights . . . . . . . . . . . . . 11
Reporting on rights . . . . . . . . . . . . . . . . . . . . . . .12
Monitoring progress . . . . . . . . . . . . . . . . . . . . . .13
For children and by children . . . . . . . . . . . . . . .14
Figures
1-1 Offi cial development assistance
(ODA), 1990–2010 . . . . . . . . . . . . . . . . . . . 9
CHAPTER 2
Promoting healthy lives . . . . . . . . . . . . . . . . .17
Goals of A World Fit for Children. . . . . . . . . . . .17
Goal: Reduction in infant and under-fi ve
mortality rates . . . . . . . . . . . . . . . . . . . . . . . . .17
Vaccine-preventable diseases . . . . . . . . . 19
Child health balance sheet . . . . . . . . . . . . 23
Goal: Policies and programmes for
adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Goal: Reduction in the maternal mortality
ratio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Maternal health balance sheet. . . . . . . . . 25
Goals: Reduction in child malnutrition and
reduction in the rate of low birth weight . . . 26
Infant and young child feeding . . . . . . . . .27
Nutrition balance sheet . . . . . . . . . . . . . . 28
Overweight and obesity . . . . . . . . . . . . . . 28
Goals: Improved access to water, sanitation
and hygiene . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Sanitation. . . . . . . . . . . . . . . . . . . . . . . . . . .31
Water and sanitation for all . . . . . . . . . . . 32
Guinea worm eradication. . . . . . . . . . . . . 33
Water and sanitation balance sheet. . . . . 33
What we can do for children . . . . . . . . . . . . . . . 34
Figures
2-1 Regional under-fi ve mortality rates,
1990, 2006 and the 2015 MDG target . . . .18
2-2 Maternal mortality ratios and lifetime
risk of maternal death, 2005 . . . . . . . . . . 24
2-3 Percentage of births attended by skilled
health personnel, 2000–2006 . . . . . . . . 25
2-4 Percentage of children under fi ve who
are underweight, 1990 and 2006 . . . . . . 26
2-5 Percentage of infants exclusively
breastfed for the fi rst six months of life,
1996 and 2006 . . . . . . . . . . . . . . . . . . . . . . .27
2-6 Percentage of households using iodized
salt, 2000–2006. . . . . . . . . . . . . . . . . . . . 29
2-7 Percentage of population using
improved drinking-water sources,
1990 and 2004. . . . . . . . . . . . . . . . . . . . . . 30
2-8 Percentage of population using improved
sanitation facilities, 1990 and 2004 . . . . 32
Boxes
2-1 Pneumonia. . . . . . . . . . . . . . . . . . . . . . . . . .18
2-2 Diarrhoea. . . . . . . . . . . . . . . . . . . . . . . . . . 19
2-3 Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
2-4 Neonatal mortality . . . . . . . . . . . . . . . . . . 22
2-5 Micronutrients . . . . . . . . . . . . . . . . . . . . . 29
CHAPTER 3
Providing quality education . . . . . . . . . . . . . .37
Early childhood development. . . . . . . . . . . . . . .37
Primary education . . . . . . . . . . . . . . . . . . . . . . . 38
Gender parity . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Secondary education . . . . . . . . . . . . . . . . . . . . . .41
Quality of education. . . . . . . . . . . . . . . . . . . . . . 43
Education balance sheet . . . . . . . . . . . . . . . . . . 47
Resources for education . . . . . . . . . . . . . . . . . . 47
Non-governmental organizations
and education . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
What we can do for children . . . . . . . . . . . . . . . 48
Figures
3-1 Net enrolment rate in primary
education, 1999 and 2005 . . . . . . . . . . . . 39
3-2 Primary completion rate, 2004 . . . . . . . . 40
3-3 Gender disparities in primary and
secondary net enrolment rates,
1990 and 2005. . . . . . . . . . . . . . . . . . . . . . .41
3-4 Net enrolment in secondary
education, 2000–2006. . . . . . . . . . . . . . . 42
3-5 Pupils per teacher in primary
education, 2004 . . . . . . . . . . . . . . . . . . . . 44
Boxes
3-1 Free education boosts enrolment
in Africa . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
3-2 Keeping school doors open in Iraq . . . . . 46
3-3 United Nations Girls’ Education
Initiative (UNGEI) . . . . . . . . . . . . . . . . . . 48
3-4 Donors leverage resources for education
in emergencies and post-crisis
transition countries . . . . . . . . . . . . . . . . . 49
Contents CHILDREN AND THE
Preface by Ban Ki-moon, Secretary-General of the United Nations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
ii CHILDREN AND THE MDGS
CHAPTER 4
Protecting against abuse, exploitation
and violence . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
Birth registration . . . . . . . . . . . . . . . . . . . . . . . . .51
Child labour . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Armed confl ict . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Child traffi cking. . . . . . . . . . . . . . . . . . . . . . . . . 56
Sexual exploitation. . . . . . . . . . . . . . . . . . . . . . . 58
Violence against children . . . . . . . . . . . . . . . . . 59
Children in confl ict with the law . . . . . . . . . . . 60
Child marriage . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Female genital mutilation/cutting . . . . . . . . . . 63
Children without parental care . . . . . . . . . . . . 64
Children with disabilities . . . . . . . . . . . . . . . . . 66
What we can do for children . . . . . . . . . . . . . . . 67
Child protection balance sheet. . . . . . . . . . . . . 68
Figures
4-1 Percentage of children under fi ve
who are not registered at birth, 1987–
2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
4-2 Estimated number of children aged
5–17 in diff erent categories of work,
2000 and 2004 . . . . . . . . . . . . . . . . . . . . . 52
4-3 Percentage of 5- to 14-year-olds who are
child labourers, 1999–2006 . . . . . . . . . . 53
4-4 Percentage of women aged 20–24
who were married or in union before
age 18, 1987–2006. . . . . . . . . . . . . . . . . . . 62
4-5 Number of orphans aged 0–17,
1990–2010. . . . . . . . . . . . . . . . . . . . . . . . . 65
Boxes
4-1 Recommendations of the UN study on
violence against children . . . . . . . . . . . . . 67
CHAPTER 5
Combating HIV and AIDS . . . . . . . . . . . . . . . .71
Mother-to-child transmission . . . . . . . . . . . . .71
Providing paediatric treatment . . . . . . . . . . . . .73
Infection among adolescents and
young people . . . . . . . . . . . . . . . . . . . . . . . . . . . .75
Children aff ected by HIV and AIDS . . . . . . . . . .77
Unite for Children, Unite against AIDS . . . . . . . . 79
HIV and AIDS balance sheet. . . . . . . . . . . . . . . 80
What we can do for children . . . . . . . . . . . . . . . .81
Figures
5-1 Percentage of HIV-infected pregnant
women receiving antiretroviral
prophylaxis for PMTCT, 2005 . . . . . . . . . .72
5-2 Percentage of children under 15 in
need of antiretroviral treatment who
are receiving it, 2006 . . . . . . . . . . . . . . . . 74
CHAPTER 6
Not enough . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
ENDNOTES . . . . . . . . . . . . . . . . . . . . . . . . 86
ANNEX
A World Fit for Children country
and territory reports . . . . . . . . . . . . . . . . . . . 90
MILLENNIUM DEVELOPMENT GOALS
PROGRE SS TOWARDS A WFFC iii
PROGRE SS TOWARDS A WFFC v
At the 27th Special Session of the General Assembly
in May 2002, Governments committed to
a set of time-bound and specifi c goals, strategies
and actions in four priority areas for the rights and
well-being of children: promoting healthy lives;
providing quality education; protecting against abuse,
exploitation and violence; and combating HIV/AIDS.
These commitments reaffi rmed and complemented
the Millennium Declaration and its goals as a
framework for development and a means for decisively
reducing poverty.
This report provides new information and analysis
on how far the world has come in reducing child and
maternal mortality and malnutrition, ensuring universal primary education,
protecting children against abuse, exploitation and violence, and combating HIV/
AIDS. It is based on an extensive and valuable set of reports by United Nations
Member States, which show that results are mixed, but positive in many respects. In
the fi ve years since the Special Session, there has been progress in many countries;
but the national reports make clear that actions are still needed everywhere to
accelerate progress.
Together, we can reach these critical goals, if we act now and with renewed resolve.
This requires us to invest more in basic social services, enhance public-private
partnerships, scale up strategies, and provide a healthy, safe and protective
environment for children.
The evidence and analysis in this report point to clear directions for our
collective efforts to build a world in which all children can survive, grow
and develop to their full potential, protected from the many threats that
jeopardize their rights. I commend it to all delegates to the General Assembly’s
commemorative high-level plenary meeting in December 2007, and to all
individuals and organizations dedicated to building a world fit for children.
Ban Ki-moon
Secretary-General of the United Nations
Preface
What have
we done for
children?
CHAPTER
1
1
Parents take pride in the progress of their children. They are delighted to see another
daughter or son enter the world. They are proud to witness the infant taking his or her
fi rst faltering steps, and they feel a mixture of pleasure and apprehension as the child
leaves for the fi rst day at school. Family stories tend to be tales of sons and daughters.
When old friends meet and exchange family news, one of the fi rst questions is, How are
the children?
A similar mixture of hope and concern is evident in the global family. When the
international community refl ects on its achievements and failures it soon asks
about its youngest members. What have we done for children? Are today’s children
healthy and well nourished? Are they going to school? Are they protected from harm
and preparing themselves for adult life?
These questions have echoed down the years at a series of international gatherings.
One of the principal landmarks was in 1989, when the UN General Assembly adopted the Convention on the Rights of the Child (CRC). It says that children ‘should be
fully prepared to live an individual life in society, and brought up in the spirit of the
ideals proclaimed in the Charter of the United Nations’.
This was soon followed, in 1990, by the remarkable World Summit for Children, at
which 159 Heads of State and Government and other high-level representatives proclaimed that ‘there can be no task nobler than giving every child a better future’. And
just as parents are willing to sacrifi ce for their children, so the governments at the
Summit promised that they would always act in the ‘best interests of the child’ and
ensure that children would have ‘fi rst call’ on all resources. To put these promises
into eff ect they established a Plan of Action incorporating 27 specifi c goals relating
to children’s survival, health, nutrition, education and protection.
This focus on children continued. Ten years later, in 2000, the world’s leaders met
and signed the Millennium Declaration, pledging ‘to free our fellow men, women
and children from the abject and dehumanizing conditions of extreme poverty’. Soon
after, they also committed themselves to a series of targets that came to be known as
the Millennium Development Goals (MDGs), all of which involve the rights of the
world’s children.
Lest there be any doubt, these commitments were reiterated in May 2002, when the
General Assembly devoted its 27th Special Session exclusively to children, in order
to review progress since the 1990 Summit. While acknowledging many achievements, they concluded that they were still falling short. They adopted a Declaration
committing themselves to seizing ‘this historic opportunity to change the world for
and with children’.
The resulting plan of action aimed to create a world fi t for children, one in which all
children get the best possible start in life. The plan emphasized that families, the
basic units of society, have the primary responsibility, and that they and other caregivers should have the appropriate support so they can enable children to grow in
2 CHILDREN AND THE MDGS
Five years a er the
Special Session, more
than 120 countries
and territories have
prepared reports on
their eff orts to meet
the goals of A World
Fit for Children.
a safe and stable environment. With the plan, governments committed to a timebound set of specifi c goals, strategies and actions in four priority areas: promoting
healthy lives; providing quality education; protecting against abuse, exploitation and
violence; and combating HIV and AIDS.
Five years after the Special Session, more than 120 countries and territories have prepared reports on their eff orts to meet the goals of ‘A World Fit for Children’ (WFFC).
Most have developed these in parallel with reports on the Millennium Development
Goals, carrying out two complementary exercises. Reports on the Millennium
Development Goals highlight progress in poverty reduction and the principal social
indicators, while the World Fit for Children reports go into greater detail on some
of the same issues, such as education and child survival. But they also extend their
coverage to child protection, which is less easy to track with numerical indicators.
The purpose of this document is to assemble some of the information contained in
these reports, along with the latest global data – looking at what has been done and
what remains to be done. It is therefore organized around the four priority areas
identifi ed in A World Fit for Children, discussing each within the overall framework
of the Millennium Development Goals.1
To appreciate the achievements for children over the past two decades, it is also useful to refl ect briefl y on how their world has changed. Children born in 1989, the year
when the Convention on the Rights of the Child was adopted, are now on the brink
of adulthood. They have lived through a remarkable period of social, political and
economic transformation.
Opportunities for participation
One change is that today’s children and young adults have many more channels for
social and political participation. In fact, members of the generation of 1989 may
already have exercised their right to vote. Many have also witnessed momentous geopolitical changes. The years following the break-up of the Soviet Union, for example,
off ered millions of people far more scope to express their views, often as citizens of
new states, and many other countries have moved from authoritarian rule to democracy. The growth of the United Nations refl ects that increasing diversity: In 1990 the
United Nations had 159 members; in 2007 it has 192.
The Convention on the Rights of the Child underscored the importance of child participation: ‘States Parties shall assure to the child who is capable of forming his or her
own views the right to express those views freely in all matters aff ecting the child, the
views of the child being given due weight in accordance with the age and maturity of
the child’. The UN Special Session on Children itself benefi ted from the presence of
child representatives from all over the world who prepared the children’s declaration ‘A World Fit for Us’.
Since then, as is clear from the World Fit for Children country reports, children have
increasingly been making their voices heard in their schools, in their communities
and even at the level of national politics – and in many diff erent ways according to
their own capacities and inclinations. Some speak through clubs or associations,